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Sudation): a Clinical Application of Heat Stress

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Sudation): a Clinical Application of Heat Stress Brief Communication Scientific exploration on physiological basis of Svedana Karma (Sudation): A clinical application of heat stress. Saurabh Yadav1, Vandana Verma2, Abhinav3 1Assistant professor, Himalayiya Ayurvedic P.G. Medical College& Hospital,Dehradun, India. 2Assistant professor, Department of KriyaSharir, Faculty of Ayurveda, Institute of Medical Science,Varanasi, India. 3Assistant professor, Department of KayaChikitsa, Faculty of Ayurveda, Institute of Medical Science,Varanasi, India. ABSTRACT Now researchers have focused attention on exploring the mechanism of acute responses of heat stress given in heat therapy that ultimately promotes the long term health benefits. Heat therapy is not a new idea rather it was practiced since thousands years back in the form of hot bath, sauna bath, steam room. Similarly in Ayurveda there is very comprehensive description of heat therapy in the form of Svedan karma (Sudation therapy). Svedan is a process to induce sweating artificially in a patient who had already undergone Snehan. Svedan is applied for purification of body, as well as in management of various disorders originated due to vitiation of Vata, Kapha Dosha, Meda Dhatu and musculoskeletal disorders. It produces various beneficial effects by augmenting the Agni like clears the channels, liquefies the deposited Dosha, regulates Vata Dosha, helps in removal and pacification of Dosha, augments metabolism (Agni Deepan), increases appetite, flexibility in body parts, softness and shining of skin, removes coldness, stiffness, drowsiness, improves joint motility. However, Svedana karma is vastly used by Ayurveda Physicians in treatment of various disorders but the mechanisms of beneficial effects produced by Svedan Karma are yet not completely explored on scientific basis. In this article, we will discuss and try to establish a possible mechanism of action of Svedana karma in relation to heat stress, mitochondrial adaptation, heat shock protein (HSP) and glucocorticoids as these are secreted under stressful conditions. Keywords: Heat therapy, Svedana(Sudation), Panchkarma, Heat shock protein INTRODUCTION Pitta dosha, Vyana and SamanaVata and Svedavahasrotas. Excessive and less sweating has been described as a Svedana karma (Sudation) is a procedure to induce sweating by characteristic in various disorders like Kushtha, Vatarakta and heating the body. It is of two kinds i.e. Saagni and Niraagni. excessive sweating in MedaRogas, Jwar. (Charak Samhita In SaagniSveda, sweating is induced by applying external heat Chikitsasthana 7/12; 29/16; Charak Samhita Sutrasthana 21/4). via various methods; it is similar to passive heat therapy. While When an individual adopts unhealthy dietary regimen for long in NiragniSveda, sweating is induced without application of time the Dosha get vitiated. The vitiated Dosha circulate in external heat rather heat generation in body is increased by whole body and get lodged in various channels (Khavaigunya) adopting certain measures e.g. doing exercise, heavy clothing and produce various ailments in them. etc. Svedana is used as Purvakarma (pre-procedure) before Ayurveda has advised various measures to balance Panchak-arma procedures and also as main treatment modality VriddhaDosha among them are Purvakarma (Snehana and for pacification and removal of VriddhaDosha. Tridosha are Svedan), PradhanaPanchakarma i.e. five procedures to remove biological entity present in each and every cell of the body, Mala i.e. vitiated Dosha and toxins accumulated in the Srotas responsible for both physiological and pathological states in the from body by targeting the different Srotas i.e. Purishavha, body. Sweating is produced because of Ushna property (hot Mutravaha, SvedavahaSrotas. Purvakarma (pre-procedures) is potency) of Pitta Dosha. Sweating is a physiological done before Panchakarma and by applying Purvakarma i.e. phenomenon for temperature regulation of the body and also Snehan and Svedan, the accumulated Dosha in minute Srotas helps in excretion of various metabolites. There is gets mobilized to Kostha. physiological variation in quantity and quality of sweat as per Ayurveda scholars were well acquainted with the function psychosomatic constitution (Charak Samhita Vimanasthana of sweat and Svedavahasrotas like eliminating toxins have 8/96). Normal sweating reflects the physiological state of the successfully designed and introduced as the SvedanChikitsa. Svedan is a process to induce sweating artificially in a patient 2Corresponding author :VandanaVerma who had already undergone Snehan etc. Effects produced by E-mail: [email protected] Svedan are it liquefies the Doshas, (eliminates the metabolic Received Jul25, 2019; Accepted Aug 13, 2019; Published Aug 31 waste), clears the obstruction of channels (improves circulation, 2019 exchange across cell membrane), reduces water retention i.e. doi: http://dx.doi.org/10.5667/tang.2019.0012 reduces Stambha (stiffness), Vatanulomana and directs the ©2019 by Association of Humanitas Medicine This is an open access article under the CC BY-NC license. Dosha to selective places from where they can be expelled (http://creativecommons.org/licenses/by-nc/3.0/) easily. TANG / www.e-tang.org 2019 / Volume 9 / Issue 3 / e4 1 Scientific exploration on physiological basis of Svedana Karma (Sudation): A clinical application of heat stress. Snehan and Svedan are majorly used procedure out of REVIEW AND DISCUSSION ShadvidhaChikitsaUpkrama, so there is need to explore the possible mechanism of action of Svedan in relation to Svedan Karma contemporary science because the people of present era are Svedan Karma is one of the important procedures in more inquisitive about mechanism of action and they are not Poorvakarma and Shadvidhupakram employed for the much aware to Dosha principles. So in this review article mode treatment of various diseases or removal of VriddhaDosha from of action of Svedan Karma is explained with help of available the body. Principally, Svedan (fomentation) is designed to literature of traditional and contemporary science. induce sweating by application of heat. It may be administrated as Poorvakarma or chief procedure or Paschata Karma. In Svedan Karma sweating is induced by application of external MATERIALS AND METHODS heat to the body (SaagniSveda) or heat production is increased by adopting some modality (NiraagniSveda) like A comprehensive study was undertaken on the descriptions of Vyayam(physical activity), Gurupravarna (warm clothing)etc. Svedan karma, Purvakarma found in different Ayurvedic As a matter of fact secretion of sweat is the physiological Samhita. Descriptions were collected from various Ayurvedic function of the body, but some artificial means can be Samhita and research papers published in scholarly journals employed for increased production of sweat in various diseases were searched online from scientific electronic databases viz. especially associated with stiffness, heaviness and coldness. PubMed, Google scholar, Science Direct by using the following Depending upon the etiology, severity and symptoms of the key phrases: sweating, effects of Svedan karma, Panchakarma, disease, it may be either RukshaSvedan (without prior oleation stress response to heat and application of heat therapy. Results therapy) or SnigdhaSvedan (with prior oleation therapy) or were analyzed in view of contemporary science to understand Niragni (without external application of heat) and the physiological basis of Svedan Karma and its applications SaagniSvedan (application of external heat). It has a significant described in Ayurveda. role in curing the various diseases but due to faulty intervention may result in various complications. So it is always As per Sthana (site) As per Agni (heat application) Aa per Guna (property) 1.Ekanga Sveda 1.Sagni 1.Ruksha Sveda DvividhaBheda(2 2. SarvangaSveda 2.Niragni 2. SnigdhaSveda types) (Charak Samhita Sutrasthana (Charak Samhita Sutrasthana (Charak Samhita Sutrasthana 14/65-66) 14/64-65) 14/64-65) TrividhaBheda As per RogiBala&Rogabala(strength of disease and patient ) (3types) 1.Mridu 2. Madhya 3. Maha(Charak Samhita Sutrasthana 14/7) Chaturvidha 1.Tapa 2. Ushma 3. Upanaha 4. Drava (Sushruta Samhita Chikitsathana 32/3) (4 types) Saptavidha 1. Loshtha 2. Vashpa 3. Agni 4. Ghati 5. Jala 6. Phala 7. Baluka (Harita Samhita Fourth Sthana 4/1) (7 types) 1. Hasta 1. Mamsa 1. Sankar 2. Pradeha 2. Urada&Tila 2. Prastara 3. Nadi 3. Baluka 3. Pariseka 4. Prastar 4. Kumbhi 4. Nadi Ashtavidha 5. Sankar 5. Pinda 5. Droni (8 types) 6. Upanaaha 6. Ishtika 6. Jala 7. Avagaha 7. Prastar 7. Upakoshtha 8. Pariseka 8. Sankar 8. Kuti (Kashyapa Samhita Sutrasthana (Vangsen) (Bhela Samhita Sutrasthana 22/1) 23/25-26) 6.Bhaya (Fear) 1. Vyayama (Exercise) 7.Krodha( Anger) Dashavidha 2.UshnaSadan (warm Rooms) 8. Upanaha (Poultice) (10 types) 3. Guru Pravarana (Heavy Clothing) 9.Avaha (War) 4.Kshudha (Hunger) 10.Atapa(Sunbath) (Sushruta Samhita Chikitsathana 5. Bahupana (Excessive Drinking) 32/3; AshtangaSangrahaSutrasthana 26/17) 1. Sankar(Mixed Fomentation) 8. KarsuSveda (Trench Sudation) 2. Prastar (Hot bed fomentation) 9.KutiSveda (Cabin Sudation) 3.Nadi Sveda (Steam Catte Fomentation) 10.Bhu Sveda(Ground Bed Sudation) Trayodashavidha 4.Parisheka (Sprinkling) 11.KumbhiSveda( Pitcher Bed Sudation) (13 types) 5. Avagaha (Tub Bath Sudation) 12.KoopaSveda( Pit Sudation) 6.JentakaSveda (Sudatorium Sudation) 13.HolakaSveda ( Under bed Sudation) (Charak 7. AshmaghanaSveda (Stone Bed Sudation) Samhita Sutrasthana 14/39-40) Table 1.Summarizing
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